Arthritis Care & Research最新文献

{"title":"Colchicine concentrations and relationship with colchicine efficacy and adverse events; post-hoc analysis of a randomised clinical trial of colchicine for gout flare prophylaxis.","authors":"Lisa K Stamp, Anne Horne, Borislav Mihov, Jill Drake, Janine Haslett, Peter Chapman, Daniel Fb Wright, Christopher Frampton, Nicola Dalbeth","doi":"10.1002/acr.25548","DOIUrl":"https://doi.org/10.1002/acr.25548","url":null,"abstract":"<p><strong>Objectives: </strong>Our objective was to examine the relationship between colchicine plasma concentrations and clinical/demographic factors, and to determine the relationship between colchicine concentrations and colchicine efficacy and colchicine-specific adverse events.</p><p><strong>Methods: </strong>Post hoc analyses were undertaken using data from a 12-month RCT involving 200 people with gout which compared low-dose colchicine to placebo for the first six months while starting allopurinol, with a further 6-month follow-up. Steady-state colchicine plasma concentrations were measured 30-80 minutes post-dose (assumed peak) and just prior to the dose (trough) at month 3 and creatine kinase (CK) at months 0, 3 and 6. Self-reported gout flares, adverse events and serious adverse events were collected monthly.</p><p><strong>Results: </strong>Peak and trough colchicine concentrations were available for 79 participants in the colchicine arm. Multivariable analysis showed that those on a statin and non-Māori/non-Pacific ethnicity were independently associated with higher trough concentrations, and age over 60 years was independently associated with higher peak concentrations. Trough and peak colchicine concentrations were significantly higher in those who had any adverse event between month 4 and 6. However, there was no association between colchicine concentrations and colchicine-specific adverse events (gastrointestinal and muscle), or with CK changes in the colchicine treated patients. Interpretation Trough or peak colchicine concentrations do not associate with gout flare prophylaxis efficacy. There is no consistent relationship between colchicine concentrations and colchicine-specific adverse events. Although colchicine concentrations increase with concomitant statin use, this does not result in muscle adverse events. These findings indicate that colchicine therapeutic drug monitoring is of limited value in clinical practice.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Rheumatology Clinical Research Year in Review, 2023-2024.","authors":"Natasha M Ruth","doi":"10.1002/acr.25549","DOIUrl":"https://doi.org/10.1002/acr.25549","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143952922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Contributors of Resilience in Youth with Childhood-Onset Systemic Lupus Erythematosus Through a Socio-ecological Lens: A Mixed Methods Study.","authors":"Isabella Zaffino, Louise Boulard, Joanna Law, Asha Jeyanathan, Lawrence Ng, Sandra Williams-Reid, Kiah Reid, Angela Cortes, Eugene Cortes, Ashley Danguecan, Deborah M Levy, Linda T Hiraki, Andrea M Knight","doi":"10.1002/acr.25550","DOIUrl":"https://doi.org/10.1002/acr.25550","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify themes contributing to resilience in childhood-onset systemic lupus erythematosus (cSLE), distinguish between profiles resilience, and examine how they relate to underlying themes and patient characteristics.</p><p><strong>Methods: </strong>We conducted a mixed-methods study of twenty-one cSLE patients aged 11-19 years at a Canadian tertiary care centre from October 2022-July 2024. We purposively sampled patients belonging to ethnically and culturally diverse backgrounds to complete semi-structured interviews. We qualitatively defined features of resilience and distinguished profiles of low vs high socio-ecological resilience according to patient median on The Child and Youth Resilience Measure-Revised (CYRM-R). Profiles were then related to socio-demographic (e.g., adverse childhood experiences, health literacy),disease features (e,g., age at diagnosis, disease duration), and patient-reported outcomes (e.g., anxiety and depressive symptoms).</p><p><strong>Results: </strong>Factors contributing to resilience were grouped into five themes: familial environment, social support beyond family, health services and information, life with SLE, and sense of self. Cultural influences were reported to impact several themes. Patients with high resilience (scores above 73 on CYRM-R) reported more facilitators in each thematic area, whereas patients with low resilience experienced more challenges in these areas, in addition to greater number of ACEs, lower health literacy, earlier age at diagnosis, longer disease duration and poorer mental health.</p><p><strong>Conclusion: </strong>Findings support a dynamic model of resilience, shaped by a combination of socio-demographic, disease, personal, cultural and social factors. This improved understanding of resilience may help direct comprehensive care for cSLE youth and guide targeted interventions for youth at risk of poor outcomes.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Letter in Support of Advocating for the Whole Patient: Supporting New Guidance on Mental Health in Pediatric Rheumatology.","authors":"Suzanne Edison, Natasha Trehan, Kathleen A Arntsen, Kate Anastasia, Jennifer Wilson, Alexander C Theos, Louise Vetter, Paul Larkin","doi":"10.1002/acr.25551","DOIUrl":"https://doi.org/10.1002/acr.25551","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Hepatotoxicity in Patients With Gout Treated With Febuxostat or Benzbromarone: A Propensity Score-Matched Cohort Study.","authors":"Wenyan Sun, Lingling Cui, Robert Terkeltaub, Ying Chen, Xinde Li, Xiaoyu Cheng, Tian Liu, Nicola Dalbeth, Changgui Li","doi":"10.1002/acr.25547","DOIUrl":"10.1002/acr.25547","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate and compare the risk of hepatotoxicity associated with the use of febuxostat and benzbromarone in patients with gout.</p><p><strong>Methods: </strong>New users of febuxostat or benzbromarone with monitoring of liver function at least three times in a year after initiation of the study drugs were identified from an electronic medical record database. Propensity score matching (PSM) was performed between the two groups 1:1 matched for age, sex, and pretreatment alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Kaplan-Meier analysis was used to estimate the probability of hepatotoxicity (defined as ALT or AST > 3× upper limit of normal). Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox regression. Subgroup analysis was performed based on age, body mass index, and comorbidities.</p><p><strong>Results: </strong>A total of 2,338 patients with gout were eligible. A total of 37% of patients experienced Common Terminology Criteria for Adverse Events version 5 grades 1 to 3 for AST or ALT abnormality. After PSM, 488 febuxostat users were matched, with 488 participants receiving benzbromarone with a mean follow-up of 1.20 years. The incidence of hepatotoxicity was 39.6 and 16.8 per 1,000 person-years for febuxostat users and benzbromarone users, respectively. Febuxostat use was associated with a significantly greater risk of hepatotoxicity than benzbromarone (adjusted HR 2.75, 95% CI 1.28-5.91), especially in patients with elevated transaminases at baseline. Findings did not differ according to prespecified subgroups.</p><p><strong>Conclusion: </strong>Febuxostat use is associated with a significantly greater risk of mild-to-moderate perturbation of liver function compared to benzbromarone in patients with gout.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Stress and Prediction of Worse Patient-Reported Outcomes in a Rheumatoid Arthritis Cohort.","authors":"Sarah L Patterson, Joonsuk Park, Wendy Hartogensis, Patricia Katz","doi":"10.1002/acr.25543","DOIUrl":"10.1002/acr.25543","url":null,"abstract":"<p><strong>Objective: </strong>Studies have suggested a potential link among traumatic experiences, psychologic stress, and autoimmunity, but the impact of stress on disease activity and symptom severity in rheumatoid arthritis (RA) remains unclear. We examined whether perceived stress independently associates with worse RA disease outcomes at subsequent visits over 18 months of follow-up.</p><p><strong>Methods: </strong>Participants were enrolled in a longitudinal RA cohort with study assessments every six months. We measured stress via the four-item Perceived Stress Scale and the following disease outcomes: patient-reported disease activity (Rheumatoid Arthritis Disease Activity Index), pain (Patient-Reported Outcome Measurement Information System [PROMIS] Pain Interference), fatigue (PROMIS Fatigue), and physical function (PROMIS Physical Function). Time-lagged linear mixed effects models evaluated longitudinal associations of stress with all four outcomes at the subsequent time point while controlling for potential confounders.</p><p><strong>Results: </strong>The sample (N = 133) was 88% female, 45% White, 35% Hispanic, 9% African American, and 6% Asian American; the mean ± SD age was 58 ± 13 years. In adjusted time-lagged longitudinal analyses, stress independently associated with greater self-reported disease activity (β = 0.11, 95% confidence interval [CI] 0.03-0.19), more pain (β = 0.61, 95% CI 0.29-0.94), more fatigue (β = 0.71, 95% CI 0.32-1.11), and lower physical function (β = -0.33, 95% CI -0.59 to -0.06). The effect size represented clinically significant differences for pain, fatigue, and physical function, but not disease activity.</p><p><strong>Conclusion: </strong>Among a longitudinal RA cohort, those with greater perceived stress had worse pain, greater fatigue, and lower physical function at follow-up. Findings underscore the need to integrate stress resilience interventions and programs that augment psychosocial support in health care systems that serve people living with RA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators for Implementing Resilience Coaching for Youth With Chronic Musculoskeletal Pain: Pediatric Rheumatologists' Perspectives.","authors":"Sabrina Gmuca, Anyun Chatterjee, Mackenzie McGill, Nellie Butler, Katherine S Kellom, Jami F Young, Tonya M Palermo, Pamela F Weiss, Abby R Rosenberg, Peter F Cronholm","doi":"10.1002/acr.25531","DOIUrl":"10.1002/acr.25531","url":null,"abstract":"<p><strong>Objective: </strong>Promoting Resilience in Stress Management (PRISM) is a resilience coaching program designed for adolescents with chronic illness. We aimed to examine the perceived feasibility, acceptability, and appropriateness of PRISM among pediatric rheumatologists treating adolescents with chronic musculoskeletal pain and obtain recommendations for improvement to inform future implementation efforts.</p><p><strong>Methods: </strong>We performed semistructured interviews with pediatric rheumatologists across several US institutions. Interviews were audio recorded and transcribed verbatim. Hybrid inductive-deductive coding was employed to capture emergent themes, guided by the Consolidated Framework for Implementation Research 2.0, and develop the codebook. We performed double coding for 20% (n = 2) of the transcriptions to develop the codebook and ensure interrater reliability.</p><p><strong>Results: </strong>Ten pediatric rheumatologists were interviewed, and feedback on PRISM was uniformly positive in terms of perceived clinical value and favorability for local implementation. Perceived facilitators included PRISM's brevity, remote delivery, and the potential for a peer group session. Finding the funding and having enough staff for such a program as well as the concerns around competing demands and building PRISM into adolescents' busy schedules were the primary perceived barriers for implementation.</p><p><strong>Conclusion: </strong>Pediatric rheumatologists report that PRISM would be valuable and of interest to their patients with chronic musculoskeletal pain, and the resilience coaching program could be further augmented by the addition of a peer support component. Implementation strategies are needed to support program costs and staffing to effectively deliver and sustain the program.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower or higher 25-hydroxyvitamin D levels associated with adverse pregnancy outcomes: comment on the article by Madanchi et al.","authors":"Gang Wang, Zhichun Liu","doi":"10.1002/acr.25545","DOIUrl":"10.1002/acr.25545","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic lupus international collaborating clinics frailty index (SLICC-FI) predicts worsening health-related quality of life, data from the almenara lupus cohort.","authors":"Anubhav Singh, Rocío V Gamboa-Cárdenas, Victor Pimentel-Quiroz, Zoila Rodriguez-Bellido, Cesar Pastor-Asurza, Risto Perich-Campos, Graciela S Alarcón, Manuel Francisco Ugarte-Gil","doi":"10.1002/acr.25544","DOIUrl":"https://doi.org/10.1002/acr.25544","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic Lupus International Collaborating Clinics-Frailty Index (SLICC-FI) as a predictor of quality of life (QoL) in systemic lupus erythematosus (SLE) patients has not been evaluated longitudinally. We estimated the association of SLICC-FI scores with future QoL in our prevalent Latin American Mestizo cohort.</p><p><strong>Methods: </strong>Patients from a single-center SLE cohort were included. Health-related (HR) QoL was ascertained with the LupusQoL and frailty with the SLICC-FI. Generalized estimating equations were performed, using each domain of the LupusQoL as an outcome in the subsequent visit, and the SLICC-FI (as a continuous variable) in the previous visit. Alternative analyses were also carried out including the SLICC-FI as a categorical variable. In both approaches, the multivariable models were adjusted for possible confounders (age at diagnosis, sex, socioeconomic status, ethnicity, SLEDAI-2K, SLICC/ACR damage index (SDI), disease duration at baseline, prednisone daily dose, antimalarial and immunosuppressive drug use, and the same domain of the LupusQoL in the previous visit).</p><p><strong>Results: </strong>Four-hundred and twenty-eight patients and 2645 visits were included in this study and they were followed for 4.71 (3.52) years. At baseline, the mean (SD) of disease duration (years), the SDI and the SLICC-FI were 7.2 (6.6), 1.0 (1.3) and 0.17 (0.05), respectively. In the main analyses, after adjusting for possible confounders, higher SLICC-FI scores predicted a worse LupusQoL in the domains of pain, planning, emotional health and fatigue. In the alternative analyses, after adjustment, frail and least fit categories were predictive of worse LupusQoL in the domain of fatigue, and frailty predicted worse body image, compared to least fit.</p><p><strong>Conclusion: </strong>Higher SLICC-FI scores predicted worse HRQoL as measured by the LupusQoL in patients from the Almenara lupus cohort. Our findings reinforce the prognostic value of this tool in SLE.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply.","authors":"Michelle Petri, Andrea Fava, Daniel W Goldman, Nima Madanchi, Laurence S Magder","doi":"10.1002/acr.25546","DOIUrl":"10.1002/acr.25546","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}